This project has three components. The Maternal and Infant Mortality Survey (MIMS) will provide estimates of maternal and infant mortality rates from population based samples in Karachi and the four provinces of Pakistan. In addition, the Survey will provide information on causes of maternal and infant deaths and demographic and other determinants of maternal and infant mortality. The Pregnancy Outcome Study (POS) is a cross sectional and prospective study of pregnant women from selected katchi abadies to identify determinants of poor birth outcome in this population. The Child Survival Study (CSS) is a follow up study of live born children from POS through two years of age to assess mortality, morbidity and physical and developmental measures. A new component is the development of an intervention to reduce infant mortality and morbidity by training all levels of care providers (dais, lady health visitors, midwives, physicians) to recognize timely high risk conditions during pregnancy or at delivery, set up a referral and transportation system and get high risk women timely referral to a tertiary medical facility.